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Skin cancer can appear between the toes, under nails, IU Simon Cancer Center expert says; May is Skin Cancer Detection and Prevention Month

INDIANAPOLIS -- (April 29, 2009) -- At first, Stephen Burke didn’t realize a blind spot was forming in his right eye. For Braden Williams, he noticed a bump on his scalp.

Both were diagnosed with melanoma -- a type of skin cancer.

Melanoma, the deadliest form of skin cancer, can appear suddenly on any part of the body or develop from a mole. Melanoma caused 8,110 of the 10,850 deaths due to skin cancer in 2007, according to the American Cancer Society.

The other types of skin cancer -- basal cell carcinoma and squamous cell carcinoma -- rarely spread, are less worrisome, and are treated differently than melanoma.

For Burke, treatment included removing his right eye shortly after his diagnosis 5½ years ago. The Fort Wayne resident has been making the two-hour drive to the Indiana University Melvin and Bren Simon Cancer Center every six months for check-ups. He’ll do so for another five years.

The bump on the fair-skinned Williams, who was 19 at the time of his diagnosis two years ago, was removed. The Speedway, Ind., resident said he comes to the IU Simon Cancer Center for regular follow-up visits.

Know your body

Lawrence A. Mark, M.D., Ph.D., an assistant professor of dermatology at the Indiana University School of Medicine and a researcher with the IU Simon Cancer Center, advises people to know their bodies and talk with their physicians about any changes they notice. Also be mindful that skin cancer can develop in places you may not consider: between the toes, on the soles of the feet, on the palms of the hands, under finger and toe nails, and on oral or genital mucous membranes.

What should you look for?

Dr. Mark tells patients to watch for what he calls the “ugly duckling” sign. “If you have a spot that just doesn’t look like any other or act like any other, it is best to have a doctor examine it, just to be on the safe side,” he said.

Dr. Mark and his colleagues use the ABCD’s to evaluate melanoma:

A, asymmetry: Half of a mole or birthmark does not match the other half

B, border: Edges are irregular, ragged, notched, or blurred

C, color: The color isn't the same all over but may have differing shades of brown or black, sometimes with patches of red, white or blue

D, diameter: The area is larger than six millimeters (about the size of a pencil eraser) or is growing larger

Most of the more than one million cases of skin cancer diagnosed yearly in the United States are considered to be sun-related, according to the American Cancer Society (ACS).

With that in mind, Dr. Mark recommends these tips for protection against the sun:

Apply sunscreen with an SPF of at least 30. Dr. Mark explained SPF this way: If your skin begins to redden after being in the sun for one minute, you could expect to be in the sun for 30 minutes while wearing an SPF of 30 before you see the same amount of reddening.

Wear appropriate clothing, such as a wide brim hat, long-sleeved shirt, and long pants.

The sun’s rays are strongest from 10 a.m. to 3 p.m. or so. Limit long periods of time outdoors during these hours.

Overall, if detected and treated early, melanoma has a greater than 95 percent cure rate.